Monday, August 15, 2011

Hot Cocoa Diagnosed

A Cocoa Chronicle Vignette by Valerie Williams-Sanchez

My sister-in-chocolate, Gloria*, had become quite unsettled, almost nervous. It was a notable and noticeable change from the normally unflappable demeanor I have known her to have since we became college friends more than two decades ago in California. Her uneasiness got my attention. After all, this is a woman who has traversed to India, Latin America and the Caribbean, several European countries and had even done a two-year bid, teaching in Central Africa, dodging termite showers and stomach parasites in post-war Chad. More, and perhaps as challenging, after surviving all of that, she'd gone on to become a high school math teacher in New York City. 

Gloria isn't an emotional light weight. But she was worried. And I could tell. She was tutoring me in math, in preparation of my sitting to take the GRE, but something else was up. It seemed she had recently had an irregular mammogram and had been scheduled for a biopsy in the coming week. She was on pins and needles about the possibilities. "One in seven women get breast cancer," she told me in true mathematician style. The look of worry seemed to give way to momentary relief at sharing what had been bothering her.  It was an opportunity to voice her fears.
I listened. 

She continued telling me about how one abnormal test had given way to another inconclusive result, and how the waiting had been tough. Then I leveled with her. If the stats were one in seven, she was probably in the clear since I too had recently had an irregular mammogram.

"But I have it," I said flatly. "I have Breast Cancer."
"Really?" she asked with incredulity.
"Really," I confirmed.

Then she asked me the question one ob-gyn, three radiologists, two breast surgeons, two reconstructive plastic surgeons and myriad nurses, physician assistants, hospital and insurance forms had posed to me previously: "How did you find the lump?"

The  Diagnosis
It began as just another lump. This time, in my left breast, the knot was like others I'd found while doing my self exam. I have had others before. I even joked one year after my annual mammogram how looking for one, which at the time was deemed benign, had been like an Easter egg hunt, in which the technician had to push, probe and prod, until the familiar mound had been hunted down, and checked. That's why this year when I was told my mammogram was irregular, I wasn't so alarmed, at least not at first. 

I knew the drill, well. A former healthcare writer for a now defunct publisher of medical and healthcare industry news and reports, I had written about breast cancer, protocols and pharmaceutical therapies that had proven efficacies in treatment years prior. I knew the disease is caused when mutant cells in breast tissue grow rampant, creating tumors which could be benign or malignant, harmless or deadly. I also knew early detection through mammogram (x-ray of the breast) is still the best method for mitigating overall all risk, since currently, there is still no cure.

More, I understood that early detection offers more treatment options and a higher likelihood for survival. This was why years ago when I worked for almost a decade for a non-profit, even before this current incident, I subscribed and paid out of pocket to maintain costly health insurance, basic care and coverage for myself and daughter, care that included my annual check-ups. In these ways alone, I was perhaps dissimilar to many other black women, according to the website, BlackDoctor.org.

And so, like for so many women with breast lumps, I thought little of it, never dreaming I would be the one in seven or eight women for whom one of those lumps, would be life changing and that on a day in June would prompt me to hear these words: "Yeah, it's breast cancer," my initial, diagnosing physician had said. "It looked suspicious," and the results confirmed it.

Breast Cancer does not discriminate.

While awaiting my test results, I had been in denial. "I'm too young for any of that," I rationalized. "Besides, I'm years away from menopause. It's probably just another cyst (a fluid-filled sac that can be drained), or maybe a fibro adenoma (an abnormal noncancerous growth)." Maybe, if left it alone, it would, "go away" as other such lumps had in the past. But this year, this time, there was a difference.

Another lump, a bit higher up my side, nearer to my under arm, marked one difference. Pre-menstrual at the time of my mammogram, I'd been directed to have an ultra-sonogram to reach a more conclusive result. And so, I lay in the radiologist's office, on yet another day, while the technician worked the goo-slathered wand, up and down, massaging my side, until even I could see gathered, rising beneath my skin a small, protruding mound. This time what I thought would turn out to be a "pseudo lump," caused by hormonal changes, wasn't.

Completely painless, the new mass and the main tumor were firm to the touch. In hindsight, and at nearly 4cm, the growths were too large to be ignored. Like the young woman in the fable, The Princess and the Pea, I had felt the mass growing all along, but after one then another benign result, I had learned to live with the knot as an irritant.

I had not forgotten about the lump, and had been keeping watch on it. Something that size isn't easy to forget. But things in my life had gotten busy for the better part of a year, as I had begun to live the life of a bi-coastal commuter, traveling between New Jersey and California for work. Through it all, I had struggled to connect with my regular ob-gyn in Irvine, Calif. to have my annual exam. I'd finally given up trying to schedule an appointment in the West, and found a new doctor in the East. I went through the usual battery of test and exams, with all the usual results – with one exception.

With almost a week ahead of me to await the test results, I had agonized over and role-played most every possible outcome, in preparation of the best and the worst. But it was one day at work that proved pivotal in my mental preparation.

My Unbroken Bat
A co-worker regularly brings in the "broken bats" from her husband's and her budding business, which packages and sells pretzel rods or "bats," to major league baseball venues on the East Coast. Almost weekly, she brings in broken pretzel sticks for us in our department to gnosh on. Much like the water cooler in other offices, the large garbage bag of broken pretzels rests atop an island of file cabinets in our department work area, serving as an informal gathering spot. The day before I received the call from my doctor, I had reached into the plastic bag and pulled out, blindly, a whole bat.  With all the others broken, mine had been the long stick pulled in some cosmic draw. I saw it as a sign.

The next day, I got the call and the request to schedule a PET-scan. This test was to determine whether the cancer had spread to other parts of my body. I took the test and, fortunately, it had not.

African American women are more likely than all other women to die from breast cancer, according to BlackDoctors.com, because for black women, tumors are found at a later, more advanced, stage so there are fewer treatment options. Poor access to healthcare or not following-up after getting abnormal test results is common among women of color. Other reasons may include distrust of the health care system, the belief that mammograms are not needed, or not having insurance.

Now "in the club" few want to be in, I've been told by other esteemed and longtime members of the "cancer club," support groups and in reading and hearing testimonials, that if I have to have cancer, breast cancer is among the best forms to have. This is because I will get everything to treat it; surgery, chemotherapy and radiation. Survival rates and quality of life following breast cancer treatment, at my levels, are high.

Thankfully, Gloria's case turned out to be a false alarm. Later, she told me she felt badly when I suggested that we celebrate her good news, given my misfortune. But to her concern, I told her: "Don't feel bad for me, I'll be living even more fully, now."

And in many ways this is true. I feel lucky, or stated differently, blessed by God and faith, to have been diagnosed and to have been afforded the resources that enabled swift action to address my cancer, which post mastectomy, has been determined to be a Stage II.

Ah, the luck of the draw.

V~


*Gloria is a fictitious name. This name has been changed to maintain anonymity. 

© 2011 Valerie Williams-Sanchez. All rights reserved.

2 comments:

Anonymous said...

Have you had a BreastCancer scare?

LaffinLam said...

This is an amazing post VLWS. Much love to you and your fam as you're going though this.